The study of functional outcome in traumatic thoracolumbar spine fractures treated with Moss-Miami instrumentation


  • Yatish Ramalingaiah Department of Orthopaedics, KIMS, Bangalore, Karnataka, India
  • Channappa T. Seetharam Department of Orthopaedics, KIMS, Bangalore, Karnataka, India
  • Manju Jayaram Department of Orthopaedics, KIMS, Bangalore, Karnataka, India
  • Shivakumar H. Bachappa Department of Orthopaedics, KIMS, Bangalore, Karnataka, India
  • Pranjay Sharma Department of Orthopaedics, KIMS, Bangalore, Karnataka, India



Moss-Miami, Thoraco lumbar fractures, Spine fractures


Thoraco lumbar fractures are grave injuries of utmost concern. If left untreated may result in marked morbidity and disability to the patient. Most of the polytrauma patients suffer from spine fractures which in turn can be associated with neurological deficits which makes the treatment of the spine fractures an important entity. Hence the present study was undertaken to study efficacy, evaluate the clinical and radiographic results, to study the advantages, complications and to facilitate early mobilization of patients and thus helping easy nursing care of the patients in order to recreate a stable, pain free spinal column by using Moss-Miami (pedicular screw). This prospective study was undertaken in the department of orthopaedics KIMS hospital and research centre, Bangalore, conducted on 20 patients fulfilling the inclusion and exclusion criteria. This study was undertaken from December 2020 to June 2022. Patients were followed up at 6, 12 and 24 weeks for data collection. The mean age of the study group was 45.7 years. The most common vertebrae involved in this series were between T11-L2 to the extent up to 65%. Among all the subjects 75% were able to return to previous employment with some restriction 75% had occasional minimal pain with no need for medication. The results of this study demonstrate the superiority of pedicle screw-rod instrumentation as a treatment for vertebral fracture with very high statistical significance in restoration of vertebral body height, mean regional angle, mean anterior wedge angle and considerable amount of neurological healing.


Hasler RM, Exadaktylos AK, Bouamra O. Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study. Eur Spine J. 2011;20:2174-180

Gertzbein SD. Scoliosis research society. Multicenter spine fracture study. Spine. 1992;17:528-40.

Oliver M, Inaba K, Tang A. The changing epidemiology of spinal trauma: A 13-year review from a level I trauma centre. Injury. 2012;43:1296-300.

Wang H, Zhang Y, Xiang Q. Epidemiology of traumatic spinal fractures: Experience from medical university-affiliated hospitals in Chongqing, China, 2001-2010. J Neurosurg Spine. 2012;17:459-68.

Burney RE, Maio RF, Maynard F. Incidence, characteristics, and outcome of spinal cord injury at trauma centres in North America. Arch Surg. 1993;128(5):596-9.

Benson DR. Keenen TL. Evaluation and Treatment of Trauma to the Vertebral Column. J Bone Joint Surg. 1990;39:577-88.

Denis, Francis: the three-column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine, (1983), 8: 817.

Jansson KA, Blomqvist P, Svedmark P. Thoracolumbar vertebral fractures in Sweden: An analysis of 13,496 patients admitted to hospital. Eur J Epidemiol. 2010;25:431-7.

Leventhal MR. Fractures, dislocations, and fracture dislocations of spine. Campbell’s Operative Orthopedics, Edited by Canale ST, 9th edn. 1998;3:2747-79.

Guttman L. “Spinal cord injuries-comprehensive management and research. Oxford: Blackwell Scientific Pblications. 1976;137-76.

Watson-Jones R. Fractures and Joint Injuries. Ed. J.B. Wilson, Edinburgh: Churchill Livingstone. 1982; 789-92.

Aebi ME, Kehl C, Thalgott TJ. The internal skeletal fixation system. A new treatment of thoracolumbar fractures and other spinal disorders. Clin Orthop. 1988;227:30.

Bucholz RW, Heckman JD. Rockwood and Greens Fractures in adults”; Lippincott Willams and Willkins; 5th edition. 2001;2:1293-466.

Francaviglia N, Bragazzi R, Maniello M, Berucci C. Surgical treatment of fracture of thoracic and lumbar spine via the transpedicular route. Bri J Neurosurg. 1995;9(4):511-8.

Uzumcugil O, Dogan A, Yetis M, Yalcinkaya, Caniklioglu M. Results of ‘Two above-one below approach’ with intermediate screws at the fracture site in the surgical treatment of thoracolumbar burst fractures. Kobe J Med Sci. 2010;56(2):E67-78.

Alvine GF, Swain JM, Asher MA, Burton DC. Treatment of thoracolumbar burst fractures with variable screw placement or Isola instrumentation and arthrodesis: case series and literature review. J Spinal Disord Tech. 2004;17(4):251-64.

Sasso RC, Cotler HB, Reuben JD: Posterior Fixation of Thoracic and Lumbar Spine Fractures using DC Plates and Pedicle Screws. Spine. 1991;16:S134-S139.

Razak M, Mahmud MM, Hyzan MY, Omar A, Short segment posterior instrumentation, reduction and fusion of unstable thoracolumbar burst fractures– a review of 26 cases. Med J Malaysia. 2000;55:9-13.

Nasser R, Yadla S, Maltenfort MG, Harrop JS, Anderson DG, Vaccaro AR, et al. Cervical fusion for degenerative disease: A comprehensive cost analysis of hospital complications in the United States from 2002 to 2014. J Neurosurg Spine. 2010;13(2):144-57.






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